| NPI | 1295800407 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NANCY LYNN MCSTOCKARD Director Of Billing 641-472-1684 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2006-11-22 |
| Last Update Date | 2020-08-22 |